2.Research progress of the role of postoperative pain in the development of postoperative cognitive dysfunction in geriatric patients.
Xiaohui CHEN ; Xiaoqiang REN ; Yabing MA ; Li GE ; Zhongyuan HU ; Wenjun YAN
Journal of Southern Medical University 2019;39(9):1122-1126
Previous studies have shown that postoperative cognitive dysfunction (POCD) is related to multiple factors including age, postoperative trauma, inflammation, postoperative pain, and anesthesia, among which postoperative pain is thought to play an important role in the development of POCD. This review summarizes the recent findings in the study of the role of postoperative pain in the pathogenesis of POCD in light of nerve injuries, neural remodeling and stress, and the progress in the prevention and treatment of POCD in elderly patients. It is of vital important to assess the postoperative pain and formulate adequate analgesic regimens for effective prevention and management of POCD to protect the brain functions of elderly patients.
Aged
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Cognitive Dysfunction
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etiology
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Humans
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Inflammation
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Pain, Postoperative
;
complications
;
therapy
;
Postoperative Complications
3.RE: Percutaneous Retroperitoneal Access.
Bilal BATTAL ; Serhat CELIKKANAT ; Veysel AKGUN ; Bulent KARAMAN
Korean Journal of Radiology 2014;15(1):179-180
No abstract available.
Catheterization/*methods
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Drainage/*methods
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Humans
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Male
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*Pancreaticoduodenectomy
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Postoperative Complications/*therapy
5.Effect of preoperative intervention of electroacupuncture at point on postoperative complications of procedure for prolapsed and hemorrhoids.
Chinese Acupuncture & Moxibustion 2019;39(3):253-256
OBJECTIVE:
To explore effective treatments that can alleviate postoperative complications in patients with procedure for prolapsed and hemorrhoids (PPH).
METHODS:
Sixty patients with pre-mixed hemorrhoids PPH were randomly divided into a simple operation group and a preoperative electroacupuncture intervention group, 30 cases in each group. PPH routine treatment was given in the simple operation group. Electroacupuncture (EA) was applied at point 30 min before PPH in the preoperative electroacupuncture intervention group, and EA was applied at Ciliao (BL 32) and Xialiao (BL 34) for 30 min. The scores of anus pendant, pain degree and persistent time and first urination time were compared within 24 h after operation between the two groups.
RESULTS:
The scores of anal pendant and pain degree in the 6 h, 12 h, 18 h, the persistent time of anal pendant and pain degree within 24 h and first urination time were better in the preoperative electroacupuncture intervention group than those in the simple operation group, and there were statistically significant differences (all <0.05).
CONCLUSION
Electroacupuncture at point 30 min before PPH can not only decrease the degrees of anal pendant and pain in the 6 h, 12 h, 18 h, but also shorten the persistent time of anal pendant and pain within 24 h after surgery and promote the first urination.
Acupuncture Points
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Electroacupuncture
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Hemorrhoids
;
therapy
;
Humans
;
Postoperative Complications
;
Preoperative Care
6.Therapy of both surgical and non-surgical related complication of gastric cancer for the elderly.
Chinese Journal of Gastrointestinal Surgery 2016;19(5):502-506
Gastric cancer is one of the most common digestive malignant tumors. More and more elderly gastric cancer patients are diagnosed and need to undergo surgical treatment as the population ages. Since the elderly patients decrease in organ function and increase in internal diseases, the tolerance to anesthesia and surgery is poor. As a result, the incidence of surgical and postoperative complications is obviously higher. Complications can be divided into surgical complications and non-surgical related complications. Surgical complications consist mainly of hemorrhage, anastomotic leakage, anastomotic dehiscence and intestinal obstruction, while non-surgical related complications include deep venous thrombosis, pulmonary infection, anesthesia-related complication, abdominal infection, urinary infection, incision infection, poor wound healing, gastroparesis, gastroesophageal reflux disease, dumping syndrome and so on. Hence, we should consider more about the elderly patients' physical condition instead of the extent of radical operation. To reduce complications, we should evaluate the organ function and take an active role in underlying diseases before operation. Meanwhile, high quality nursing, powerful analgesia, anti-inflammation, keeping water electrolyte balance and nutrition support are also required postoperatively. Moreover, laparoscopic surgery and enhanced recovery after surgery (ERAS) can reduce the postoperative complications in elderly patients with gastric cancer as well. Further prospective randomized controlled trials about elderly gastric cancer should be carried out in the future, which can provide advanced evidences for treatment.
Aged
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Anastomotic Leak
;
therapy
;
Hemorrhage
;
therapy
;
Humans
;
Laparoscopy
;
Postoperative Complications
;
therapy
;
Postoperative Period
;
Stomach Neoplasms
;
complications
;
surgery
;
Surgical Wound Infection
;
therapy
7.A Retrospective Clinical Study: Complications of Totally Implanted Central Venous Access Ports.
June Pill SEOK ; Young Jin KIM ; Hyun Min CHO ; Han Young RYU ; Wan Jin HWANG ; Tae Yun SUNG
The Korean Journal of Thoracic and Cardiovascular Surgery 2014;47(1):26-31
BACKGROUND: When managing patients who require repeated venous access, gaining a viable intravenous route has been problematic. To improve the situation, various studies on techniques for venous access have been conducted. The aim of this study is to evaluate the clinical results of complications following totally implanted central venous access port (TICVAP) insertion. METHODS: A retrospective analysis was conducted on 163 patients, from December 2008 to March 2013. The occurrence of complications was studied in three separate periods of catheter use: the intraoperative period, postoperative period, and period during the treatment. RESULTS: A total of 165 cases of TICVAP insertions involving 156 patients were included in the final analysis. There were 35 complications (21%) overall. Among these, 31 cases of complications (19%) occurred during the treatment period and the other 4 cases were intraoperative and postoperative complications (2%). There were no statistically significant differences in age and gender of the patients between the two groups to be risk factors (p=0.147, p=0.08). Past history of chemotherapy, initial laboratory findings, and the locations of TICVAP insertion also showed no statistical significance as risk factors (p>0.05). CONCLUSION: Because the majority of complications occurred after port placement and during treatment, meticulous care and management and appropriate education are necessary when using TICVAPs.
Catheters
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Chemotherapy, Adjuvant
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Drug Therapy
;
Education
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Humans
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Intraoperative Complications
;
Intraoperative Period
;
Postoperative Complications
;
Postoperative Period
;
Retrospective Studies*
;
Risk Factors
8.Clinical study of Ruiyun procedure for hemorrhoids combined with Xiaozhiling injections in treatment of hemorrhoids complicated with human immunodeficiency virus infection.
Guo WEI ; Xin HUA ; Yong ZHAO ; Minghui HU ; Fang GOU ; Lin LIU ; Lin CAI ; Yong HE ; Shenghua HE
Chinese Journal of Gastrointestinal Surgery 2014;17(12):1201-1204
OBJECTIVETo explore the efficacy of Ruiyun procedure for hemorrhoids (RPH) combined with Xiaozhiling injection in the treatment of hemorrhoids complicated with human immunodeficiency virus (HIV) infection and its influence on cellular immune function.
METHODSClinical data of 76 hemorrhoid patients, including 36 positive HIV and 40 negative HIV, undergoing RPH combined with Xiaozhiling injections in our center from January 2010 to December 2012 were retrospectively analyzed. Clinical efficacy and cellular immune function preoperative day 1, postoperative day 7, 30 were compared between positive and negative groups.
RESULTSRecurrence rates of positive group and negative group postoperative 6 months were 22.2% (8/36) and 22.5% (9/40), postoperative 1 year were 30.6% (11/36) and 30.0% (12/40) without significant differences (all P>0.05). Morbidity of postoperative complication was also not significantly different between two groups (P>0.05). According to HIV classification, peripheral lymph cell ratio, CD4 count, CD4/CD8, white blood cell count and neutrophil ratio were not significantly different between preoperative day 1 and postoperative day 7 in both groups (all P>0.05). Decreasing velocity and amplitude of CD4 in both groups from high to low was HIV III, HIV II, HIV I, HIV-, while after 30 days the increase of CD4 from high to low was HIV-, HIV I, HIV II, HIV III, which were significantly different as compared to postoperative day 7 (all P<0.05).
CONCLUSIONSRPH combined with Xiaozhiling injection in the treatment of hemorrhoids complicated with HIV infection is effective and safe. Postoperative inhibited cellular immune function can recover quickly.
CD4 Lymphocyte Count ; HIV Infections ; complications ; Hemorrhoids ; drug therapy ; surgery ; Humans ; Postoperative Complications ; Recurrence ; Retrospective Studies
10.Management of nutrition--and endocrine metabolism-related complications of bariatric surgery.
Acta Academiae Medicinae Sinicae 2011;33(3):228-231
Bariatric surgery has increasingly been applied for patients with severe obesity. By dramatically reducing body weight and producing favorable effects on disorders in endocrine metabolism, bariatric surgery has shown to be able to lower the overall mortality. However, this intervention involves a profound change in digestive physiology and may cause nutrition and endocrinal metabolism-related severe complications, which mainly result from the deficiency or unbalance of macronutrients and micronutrients. Therefore, it is necessary to establish a fixed management procedure which includes routine perioperative nutritional consultation, regular monitoring, and early preventive nutritional support, so as to prevent metabolic complications and achieve better outcomes.
Bariatric Surgery
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adverse effects
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Humans
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Malnutrition
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etiology
;
therapy
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Nutritional Support
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Obesity, Morbid
;
surgery
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Postoperative Complications
;
therapy